Vision statements are used to describe future goals or aims of an organization. It is a description in words that conjures up a picture for all group members of what they want to accomplish together. It is critical, then, that organization leaders recognize that the organization will never be greater than the vision that guides it. An appropriate vision statement for a hospital is shown in Display 7.4.
Philosophy
Goals
Objectives
Policies
Procedures
Rules Mission
FIGURE 7.1 • the planning hierarchy.
DISpLAy 7.4 Sample Vision Statement
County hospital will be the leading center for trauma care in the region.
An organization will never be greater than the vision that guides it.
The purpose or mission statement is a brief statement (typically no more than three or four sentences) identifying the reason that an organization exists. The mission statement identifies the organization’s constituency and addresses its position regarding ethics, principles, and standards of practice.
A well-written mission statement will identify what is unique about the organization. For example, Brozovich and Totten (2012) suggest that all hospitals want to have high-quality, cost-effective care, but mission statements that include only this verbiage do not differentiate between organizations. In addition, the mission statement should have the capacity to drive action that reflects the mission over time. In other words, mission statements can become powerful decision-making tools when they become a template of purpose for the organization’s activities (Brozovich and Totten).
Voges (2012) notes, however, that many contemporary health-care administrators find the challenges of meeting their stated mission in an era of cost cutting to be a challenge; hence the often stated adage, “no margin, no mission.” Voges concludes that balance between margin
and mission is key but warns that sustaining a health-care organization’s mission in the face of increasing economic challenges will be difficult.
An example of a mission statement for County Hospital, a teaching hospital, is shown in Display 7.5.
County hospital is a tertiary care facility that provides comprehensive, holistic care to all state residents who seek treatment. the purpose of County hospital is to combine high-quality, holistic health care with the provision of learning opportunities for students in medicine, nursing, and allied health sciences. research is encouraged to identify new treatment regimens and to promote high- quality health care for generations to come.
DISpLAy 7.5 Sample Mission Statement
The mission statement is of highest priority in the planning hierarchy because it influences the development of an organization’s philosophy, goals, objectives, policies, procedures, and rules. Managers employed by County Hospital would have two primary goals to guide their planning: (a) to provide high-quality, holistic care and (b) to provide learning opportunities for students in medicine, nursing, and other allied health sciences. To meet these goals, adequate fiscal and human resources would have to be allocated for preceptorships and clinical research. In addition, an employee’s performance appraisal would examine the worker’s performance in terms of organizational and unit goals.
Mission statements then have value, only if they provide more than lip service. Indeed, actions taken at all levels of the organization should be congruent with the stated organization mission. This is why involving individuals from all levels of the organization in crafting mission statements is so important.
Curran and Totten (2010) suggest that in seeking employment, nurses should review the mission statement of a potential employer and ask themselves what it tells them about the organization’s stakeholders, what beliefs and values are espoused, and how the organization intends to meet the needs of its stakeholders. Only then can the potential employee determine whether this is an organization they want to work for.
An organization must truly believe and act upon its mission statement; otherwise, the statement has no value.
THE ORGANIZATION’S pHILOSOpHy STATEMENT
The philosophy flows from the purpose or mission statement and delineates the set of values and beliefs that guide all actions of the organization. It is the basic foundation that directs all further planning toward that mission. A statement of philosophy can usually be found in policy manuals at the institution or is available on request. A philosophy that might be generated from County Hospital’s mission statement is shown in Display 7.6.
The organizational philosophy provides the basis for developing nursing philosophies at the unit level and for nursing service as a whole. Written in conjunction with the organizational philosophy, the nursing service philosophy should address fundamental beliefs about nursing and nursing care; the quality, quantity, and scope of nursing services;
and how nursing specifically will meet organizational goals. Frequently, the nursing service philosophy draws on the concepts of holistic care, education, and research. The nursing service philosophy in Display 7.7 builds on County Hospital’s mission statement and organizational philosophy.
the board of directors, medical and nursing staff, and administrators of County hospital believe that human beings are unique, due to different genetic endowments, personal experiences in social and physical environments, and the ability to adapt to biophysical, psychosocial, and spiritual stressors.
thus, each patient is considered a unique individual with unique needs. identifying outcomes and goals, setting priorities, prescribing strategy options, and selecting an optimal strategy will be negotiated by the patient, physician, and health-care team.
As unique individuals, patients provide medical, nursing, and allied health students invaluable diverse learning opportunities. Because the Board of directors, medical and nursing staff, and administrators believe that the quality of health care provided directly reflects the quality of the education of its future health-care providers, students are welcomed and encouraged to seek out as many learning opportunities as possible. Because high-quality health care is defined by and depends on technological advances and scientific discovery, County hospital encourages research as a means of scientific inquiry.
DISpLAy 7.6 Sample Philosophy Statement
the philosophy of nursing at County hospital is based on respect for the individual’s dignity and worth. We believe that all patients have the right to receive effective nursing care. this care is a personal service that is based on patients’ needs and their clinical disease or condition.
recognizing the obligation of nursing to help restore patients to the best possible state of physical, mental, and emotional health and to maintain patients’ sense of spiritual and social well- being, we pledge intelligent cooperation in coordinating nursing service with the medical and allied professional practitioners. Understanding the importance of research and teaching for improving patient care, the nursing department will support, promote, and participate in these activities. Using knowledge of human behavior, we shall strive for mutual trust and understanding between nursing service and nursing employees to provide an atmosphere for developing the fullest possible potential of each member of the nursing team. We believe that nursing personnel are individually accountable to patients and their families for the quality and compassion of the patient care rendered and for upholding the standards of care as delineated by the nursing staff.
DISpLAy 7.7 Sample Nursing Service Philosophy
The unit philosophy, adapted from the nursing service philosophy, specifies how nursing care provided on the unit will correspond with nursing service and organizational goals. This congruence in philosophy, goals, and objectives among the organization, nursing service, and unit is shown in Figure 7.2.
Although unit-level managers have limited opportunity to help develop the organizational philosophy, they are active in determining, implementing, and evaluating the unit philosophy.
In formulating this philosophy, the unit manager incorporates knowledge of the unit’s internal and external environments and an understanding of the unit’s role in meeting organizational goals. The manager must understand the planning hierarchy and be able to articulate ideas both verbally and in writing. Leader-managers also must be visionary, innovative, and creative in identifying unit purposes or goals so that the philosophy not only reflects current practice but also incorporates a view of the future.
Like the mission statement, statements of philosophy in general can be helpful only if they truly direct the work of the organization toward a specific purpose. A department’s decisions, priorities, and accomplishments reflect its working philosophy.
A working philosophy is evident in a department’s decisions, in its priorities, and in its accomplishments.
A person should be able to identify exactly how the organization is implementing its stated philosophy by observing members of the staff, reviewing the budgetary priorities, and talking to consumers of health care. The decisions made in an organization make the philosophy visible to all—no matter what is espoused on paper. A philosophy that is not or cannot be implemented is useless.
Goals, philosophy, and objectives of the __________ Department
Nursing Unit B
goals
Unit B philosophy
Unit B objectives
Unit C objectives
Unit C philosophy
Unit A objectives
Nursing Unit A
goals
Unit A philosophy
Nursing Unit C
goals Goals, philosophy,
and objectives of the Nursing Department Goals, philosophy, and objectives of the
health-care agency
Goals, philosophy, and objectives of the __________ Department
FIGURE 7.2 • philosophical congruence in the planning hierarchy.